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HealthOne NSW Chronic Care Forum 2007 Responding to the Challenge 19-20 September 2007 Inter-Government and Funding Strategies Branch NSW Department of Health. HealthOne NSW. A NSW government initiative to deliver integrated primary health and community care services
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HealthOne NSW Chronic Care Forum 2007 Responding to the Challenge 19-20 September 2007 Inter-Government and Funding Strategies Branch NSW Department of Health
HealthOne NSW • A NSW government initiative to deliver integrated primary health and community care services • Goal: to provide patient centred, continuing, coordinated and comprehensive care through a strong, integrated and sustainable primary care sector • Funding: NSW Government has committed: • capital funding of $40m over 5 years (06/07 – 10/11) • recurrent funding of $12.3m over 4 years (07/08 – 10/11)
HealthOne NSW services- Core characteristics(1) • General Practice and Community Health staff working together as members of a multi-disciplinary team • In a formal organisational arrangement that is different from either a conventional General Practice or a conventional Community Health Service
HealthOne NSW services- Core characteristics(2) • Providing coordinated and integrated services for a local community, that encompass: • Health promotion and illness prevention • Early detection and early intervention • Continuing care for people with chronic and complex conditions • Including planned care for those who need it
HealthOne NSW services- Core characteristics(3) • Underpinned by integration of systems for client record keepingand information sharing • Providing a locale for clinical education and training, and research • With health care consumers and the local community as active participants in services planning and care delivery
What are we aiming to do? • Prevent illness, reduce the risk and impact of disease and disability, and build personal and community resilience • Improve chronic disease management in the community • Reduce avoidable hospital admissions • Improve service access and health outcomes, especially for disadvantaged and vulnerable groups • Create better experiences for people using health services (ie improve patient journeys through the system) • Strengthen the participation of consumers and communities in health care and health service decision making • Build a sustainable model of health care delivery
HealthOne NSW – a work in progress • Two EOIs released in 2005 and 2006 respectively • Wave 1 (EOI 1) – seven HealthOne NSW services announced • EOI 2 - eight wave 2 and eleven wave 3 proposals approved in March 2007 for progression • Wave 2: project plans reasonably well developed, strong partnerships evident • Wave 3: proposals require further development and partners to be confirmed
Mt Druitt - Wave 1 - Western Sydney AHS Challenges • Urban area with very disadvantaged communities, including refugees and Aboriginal people • 38% population have income below the poverty line • Lots of solo general practitioners Service Model • Hub – community health centre • Spokes - individual general practices and satellite centre • Community health staff and GPs, with other services such as housing, child support • Focus on young families with parenting issues, young people with mental health problems and older people (over 70 years) with chronic diseases
Molong – Wave 1 – Greater Western AHS Challenges • Small rural town with an ageing population • Limited access to allied health and specialist medical care • Limited transport infrastructure Service model • Nursing services, GP services and specialist services will be co-located • Strong local government involvement • Local and visiting allied health services • Outreach services will be provided to neighbouring towns
Raymond Terrace – Wave 2 - HNEAHS Challenges • 30km from Newcastle but no direct public transport • Growing and young population (41% under 24), with large Aboriginal population and high proportion of single parent families Service model • Port Stephens Council leading master planning for health/welfare precinct which will include early childhood and family services, library, private diagnostic and allied health services etc • Community health services (eg. community nursing, allied health, women’s health, D&A) and largest GP practice will be co-located at HealthOne NSW service (part of this precinct)
Key challenge • Bringing together different clinical providers with very different business models and funding sources: • public sector Community Health staff (employed by Area Health Services) • private-for-profit General Practices (typically fee-for-service subsidised by Medicare) • (potentially) other private sector providers, eg. community nurses, allied health practitioners, pharmacists (may be funded by consumers, GPs accessing MBS items, Divisions of General Practice)
Key issues for every site • Model of service delivery – what services will be provided, by whom, to whom, where and when • Corporate governance – the decision making and accountability arrangements that will ensure that the service operates efficiently, effectively, legally and ethically • Clinical governance arrangements – that will ensure patient safety and clinical quality • IM+T arrangements – to allow sharing of clinical records and efficient team communications • Facility requirements and capital funding implications
Expert advice • Waves 1 and 2 – Expert advice up to value of $15,000 • Wave 3 – Expert advice up to value of $7,000 • Able to access nominated people with expertise in: • consultation and facilitation • corporate governance • business modelling • financial management / resourcing • integrated models of care and service delivery • information management and technology • capital planning
Evaluation Framework • STRUCTURE: Does the HealthOne NSW service have an organisation and structure that can support an effective, integrated and sustainable health service? • PROCESS: Does the HealthOne NSW service have systems and processes that enable health professionals to provide integrated care? • OUTCOMES: Do the services provided meet the needs of patients and the local community? • SYSTEM: How well does the service function as part of the wider network of health and community care services?
Building partnerships Partnership • Shared: • identity • vision • strategic purpose • responsibilities • resources • benefits Collaboration Co-ordination Co-operation Networking